ABC Medical School FMABC

Santo André, Brazil

ABC Medical School FMABC

Santo André, Brazil

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Rehder J.R.C.L.,ABC Medical School FMABC | Paulino L.V.,Cornea and External Diseases Unit | Paulino E.,Refractive Surgery Unit
Revista Brasileira de Oftalmologia | Year: 2013

This paper reviews and makes a critical analysis of radiofrequency in ophthalmology. Localized heating of the cornea has been apllied since 1889 for different therapeutic and surgical objectives.The principle that heating corneal tissue causes shrinking of the collagen that changes the corneal curvature. After the approval of FDA in 2004, we initiated amulticenter study in Brazil co ordinated by ABC School of Medicine that resulted in an analyses of 258 patients. Inconclusion the study showed that the procedure had a temporary result and the best results were obtained in patients between 45 and 55 years old without optical correction for far.We believe that the problem has not been solved yet and a great deal of research effort should be focused.


Serpa Neto A.,ABC Medical School FMABC | Serpa Neto A.,Hospital Israelita Albert Einstein HIAE | Cardoso S.O.,ABC Medical School FMABC | Ong D.S.Y.,University Utrecht | And 5 more authors.
Journal of Critical Care | Year: 2013

Purpose: Our aims were to determine whether the pulse oximetric saturation/fraction of inspired oxygen (S/F) can be used for the early identification of patients with sepsis who are at increased risk for death and to compare the S/F ratio with the Pao2/fraction of inspired oxygen (P/F) ratio. Materials and Methods: This is a retrospective cohort study in 260 patients admitted to 2 tertiary mixed intensive care units (ICUs) with severe sepsis or septic shock. We studied the association between tertiles of S/F ratio and ICU mortality using Cox regression. Subsequently, we compared corresponding measurements of S/F ratio and P/F ratio upon ICU admission using Pearson correlation coefficient (r). Results: We observed an overall case fatality of 72 (28%) of 260. After adjustment for severity of the illness, the lowest tertile (S/F, <. 164) at ICU admission was associated with increased mortality (hazard ratio, 1.87 [95% confidence interval, 1.02-3.41]) comparing to the highest tertile (S/F, >. 236). The S/F ratio was correlated with P/F ratio (r = 0.48; P < .0001). Conclusion: A low S/F at ICU admission is associated with increased risk of death in patients with severe sepsis or septic shock. © 2013 Elsevier Inc.


Bacci M.R.,ABC Medical School FMABC | Murad N.,ABC Medical School FMABC | Breda J.R.,Federal University of São Paulo | De Oliveira A.V.C.,ABC Medical School FMABC | And 3 more authors.
Revista da Associacao Medica Brasileira | Year: 2015

Introduction: valve disease is an important cause of heart failure. There is a direct relationship between valve deterioration and the patient's inflammatory status and cytokines: interleukin-6, interleukin-1, tumor necrosis factor, and C-reactive protein, involved in this major state of inflammation. Objective: to report a series of cases of valve replacement, using a bioprosthetic or mechanical valve, and the inflammatory profile of them. Methods: patients older than 18 years and with bioprosthetic or mechanical valve placed for a minimum of 6 months and maximum of 2 years were included. In addition to the demographic characteristics of each patient, inflammatory markers were measured and a comparison was made of echocardiographic results before (based on medical records) and after surgery. A total of 46 patients were enrolled, 23 with mechanical valve and 23 with bioprosthetic valve. Results: of the 46 patients, 20 presented complete data were included, 12 with bioprosthetic and 8 with mechanical valve. There was no difference between types of prosthesis or implant site for the values of inflammatory markers although they were all above reference range. Discussion: patients undergoing aortic mechanical valve implant benefited more than those undergoing bioprosthetic implant and both with much better results than those of valve replacements performed on mitral valve. In short, there was no difference in relation to inflammatory biomarkers.


Santana T.A.,ABC Medical School FMABC | Trufelli D.C.,ABC Medical School FMABC | de Matos L.L.,Abc For Health, Inc. | Cruz F.M.,Discipline of Oncology | Del Giglio A.,Discipline of Oncology
Supportive Care in Cancer | Year: 2015

Purpose: Chemotherapy-induced nausea and vomiting (CINV) is a distressing chemotherapy-induced symptom that may adversely impact the quality of life of cancer patients.Methods: We conducted a systematic search of the Pubmed, Bireme, and Cochrane databases for randomized clinical trials that were published in English and that evaluated the combination of adjunctive non-neurokinin 1 (NK1) antagonist drugs (i.e., neuroleptics, anticonvulsants, benzodiazepines, and cannabinoids) with 5-hydroxytryptamine 3 (5-HT3) antagonists for adult cancer patients who were scheduled to receive moderate or highly emetogenic chemotherapy. We employed the Review Manager (RevMan) Computer program Version 5.2 for statistical calculations.Results: We included 13 studies with a total of 1,669 patients. We observed a higher complete protection for acute CINV with adjunctive medications (risk ratio (RR) = 0.55; 95 % confidence interval (CI) 0.30–1.01; p = 0.05; I2 = 47 %), which was not the case for the delayed period (RR = 0.89; 95 % CI 0.73–1.10, p = 0.29, I2 = 15 %). We also observed that these adjunctive medications significantly increased the complete control of nausea (RR = 0.72; 95 % CI 0.55–0.95; p = 0.02, I2 = 83 %) and vomiting (RR = 0.61; 95 % CI 0.50–0.75; p < 0.00001; I2 = 60 %). There was no subgroup analysis evidence of the superiority of any single group of adjunctive medications.Conclusions: We conclude that adjunctive non-NK1 antagonist medications may be useful for CINV control. Prospective randomized studies incorporating these low-cost medications into new regimens combining 5-HT3 and NK1 antagonists may be warranted. © 2014, Springer-Verlag Berlin Heidelberg.


Candido L.R.,ABC Medical School FMABC | de Oliveira G.C.,ABC Medical School FMABC | Martinelli E.J.V.,ABC Medical School FMABC | Ribeiro L.G.I.,ABC Medical School FMABC | And 3 more authors.
Revista Brasileira de Oftalmologia | Year: 2014

Objective: To compare the influence of two techniques for corneal epithelial removal in photorefractive keratectomy (PRK) - blunt scrape versus rotary brush - regarding duration of technique application, intraoperative comfort, and reepithelization. Methods: This prospective randomized study included 58 eyes of 29 patients that underwent simultaneous and sequential PRK in both eyes - blunt scrape (scraped group) in one eye and rotary brush (brushed group) in the fellow eye. Results: The faster technique, measured in seconds, was the rotary brush (16.4 ± 6.3) compared to the blunt scrape (35.7 ± 7.6). There was no difference between the methods regarding discomfort reported by the patient during surgery and the type of symptom reported postoperatively (p>0.05). The analysis of variance (ANOVA) showed that the brushed group were related to a greater intensity of symptoms [F (8.104) = 1.5, p<0.05] and post hoc testing indicated that this difference was only significant (p<0.05) on day 2. All eyes of the 2 groups showed complete corneal epithelialization on day 5 postoperatively. Conclusion: In this study, it was found that epithelial removal with rotating brush was superior to manual only by its shorter application. It showed the same level of intraoperative discomfort and determined a greater intensity of symptoms postoperatively.


Moraes F.S.,ABC Medical School FMABC | De Moura Santos W.E.,ABC Medical School FMABC | Salomao G.H.,ABC Medical School FMABC
Revista Brasileira de Oftalmologia | Year: 2013

The neurofibromatosis type 1 is a autosomal dominant disease which the diagnosis is made based on clinical criteria. Its three main features -neurofibromas, cafe au lait macules and Lisch nodules occur in up to 90% of the pacients until puberty. We documented a clinical case of a young male pacient who had the diagnosis of neurofibromatosis type 1 and family history, describing its clinical aspects and radiological features.


Saad E.D.,Dendrix Research Ltd | Sasse E.C.,Dendrix Research Ltd | Borghesi G.,Dendrix Research Ltd | Miranda V.C.,ABC Medical School FMABC | And 8 more authors.
American Journal of Clinical Oncology: Cancer Clinical Trials | Year: 2013

OBJECTIVES: With the growing number of new anticancer therapies, randomized phase II trials have been used more often in oncology. Although the primary objective of such trials is not to formally compare results between arms, this practice seems frequent. We sought to quantify the frequency of use of formal statistical testing or inference through the use of P values and confidence intervals (CIs) in randomized phase II trials. METHODS: We searched PubMed for randomized phase II trials assessing systemic cancer therapies published in the years 1995/1996 and 2005/2006. For each study, 2 reviewers independently abstracted data, including reporting of P values and CIs for the primary endpoint. RESULTS: We retrieved 288 articles, 107 of which were eligible for analysis. The median number of patients per trial was 94, the primary endpoint was response rate in 71 (66.4%) cases, and a control arm was present in 55 (51.4%) trials. Either P values or CIs for the primary endpoint were reported in 85 (79.4%; 95% CI, 70.8%-86.1%) cases. Year of publication, source of funding, and use of a control group were not associated with this practice. CONCLUSIONS: Formal statistical comparisons between arms of randomized phase II trials are frequently undertaken in medical oncology. The extent to which such a practice abrogates phase III testing is unknown. Copyright © 2012 by Lippincott Williams &Wilkins.


PubMed | ABC Medical School FMABC
Type: Journal Article | Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer | Year: 2014

Chemotherapy-induced nausea and vomiting (CINV) is a distressing chemotherapy-induced symptom that may adversely impact the quality of life of cancer patients.We conducted a systematic search of the Pubmed, Bireme, and Cochrane databases for randomized clinical trials that were published in English and that evaluated the combination of adjunctive non-neurokinin 1 (NK1) antagonist drugs (i.e., neuroleptics, anticonvulsants, benzodiazepines, and cannabinoids) with 5-hydroxytryptamine 3 (5-HT3) antagonists for adult cancer patients who were scheduled to receive moderate or highly emetogenic chemotherapy. We employed the Review Manager (RevMan) Computer program Version 5.2 for statistical calculations.We included 13 studies with a total of 1,669 patients. We observed a higher complete protection for acute CINV with adjunctive medications (risk ratio (RR)=0.55; 95% confidence interval (CI) 0.30-1.01; p=0.05; I2=47%), which was not the case for the delayed period (RR=0.89; 95% CI 0.73-1.10, p=0.29, I2=15%). We also observed that these adjunctive medications significantly increased the complete control of nausea (RR=0.72; 95% CI 0.55-0.95; p=0.02, I2=83%) and vomiting (RR=0.61; 95% CI 0.50-0.75; p<0.00001; I2=60%). There was no subgroup analysis evidence of the superiority of any single group of adjunctive medications.We conclude that adjunctive non-NK1 antagonist medications may be useful for CINV control. Prospective randomized studies incorporating these low-cost medications into new regimens combining 5-HT3 and NK1 antagonists may be warranted.

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